Gluten intolerance as a diagnosis is now so widely used that it serves as the butt of jokes. But is it?

About 1 in 100 people have celiac disease – the genetic form. Many more have wheat allergies, and some suffer from the lectins (“anti-nutrients”) in wheat and other grains, seeds, and nuts. I won’t even mention the more than fifty percent of Americans who a seriously overweight, due to “our daily bread”.

Your health is important. When my daughter and I wandered the wild, lonely moors of Yorkshire this summer, every remote little inn and restaurant would carry gluten-free items. But we here still think it is a joke?

Yet – so many people have taken matters in their own hands, without waiting for the government to steps in and admit that not good fats are the culprits; wheat - and rye and barley and, sometimes, oats – are the offenders to our health.

Not that I should luxuriate in writing blogs while I am finishing my diabetes book, but to call attention to the problems with wheat – on this occasion I just have to do it.

Since this is my big theme presently, let me roll up the whole gluten conundrum from the diabetic side: Ninety percent of people with diabetes type II are overweight; ten percent are not. Now – what gives the ten percent their diabetes?

Genes, of course. But genes account only for part of the puzzle. Most slim diabetics have either type I diabetes (which I will not discuss here), or they have gluten intolerance. Disclosure: I am one of those ten percent, and while I don’t yet have full-blown diabetes with all the dismal consequences down the road like blindness, kidney failure, amputations, neurological damage, my number always hover at the upper border of normal or the low border of diabetes. For somebody who has brittle diabetes and ends in the hospital frequently, this seems a good place to be, and sure it is. BUT: By the time people are diagnosed with diabetes, a good third already shows sign of end-organ failure. Which means: They really already have advanced disease. I don’t want to wait doing nothing and closing my eyes.

So, what do I do? I move, for starters. I don’t go to the gym, but I work in the garden, play my cello, go for a walk after dinner with my husband, and do tiny exercises every time I get up from my chair during my long writing sessions (aaah – writing a book about health is not such a healthy thing, after all).

And I eat healthily. Fresh vegetables, fresh herbs, some fish, much less meat (but meat I do eat – and recommend), no dairy, no sugar, no sweeteners either, no trans-fats, and basically, nothing processed.

But back to gluten. We pray for our daily bread – and are not aware how recent the “daily bread” was invented – not longer than five to ten thousand years. Which is nothing in terms of evolution and our genes. Actually, our “daily bread” is around not much longer than monotheism – the belief in a single, singular god. I find that interesting: When we were hunter and gatherers, eating and nibbling and plucking from Nature wherever we went, we had multiple gods – the ones that were hidden in the groves, in the deep lakes, in the skies – and everything was whispering to us: Holy, holy, holy.

Then agriculture was invented with cattle and sheep husbandry, and we learned to sow and to reap, and suddenly there was that one stern god over us, telling to adhere to his rules – one obviously needs rules and timetables and schedules and order to be a farmer.

Forward a few thousand years to Mr. Kellogg, who gave us our breakfast cornflakes, and modern scientists who gave as bigger kernels of wheat, and then all the abundance that came with industrialization and prosperity – and here comes the modern American wave of obesity and diabetes. Where for millions of years always was scarcity – and that is what our bodies were adapted to for millions of years – now we can get the whopping calories of a burger for one dollar. Without to move out into the woods and hunt and gather.

If gluten is at the root of those ten percent of slim diabetics – so what! you exclaim, because you are fighting the pounds for most of your life. Gluten makes a few of us very sick – with celiac disease. Gluten makes a lot of us fat, with sickness down the road from the excess pounds.

Celiacs have no immune tolerance for gluten; they might get diarrhea, skin rashes, bloating, and all kinds of weird symptoms – including neurologic and psychiatric. Half of the symptoms are not showing in the belly, which is one reason gluten intolerance is still one of the widely under-diagnosed disease – even that the last ten years has turned the tide a bit.

The funny thing is: Wheat does not want to be eaten. Like basically all nuts and seeds, the wheat grain contains a family of compounds called lectins that are there to protect the grain from being eaten. The wheat plant has no interest, so to speak, to be gobbled up and extinguished. On the other hand, from the wheat’s point of view, of course, it is extremely advantageous that farmers everywhere now growing this seed that originally had a very narrow distribution, namely the Fertile Crescent of Mesopotamia. Somehow we managed to spread it more or less worldwide – or did the plant entice us to do its business?

Not sure. But nuts and seeds contain lectins that hinder digestion and make people sick with arthritis, depression, heart disease, cancer, diabetes, and so on – the celiac who runs to the bathroom ten times a day is only the tip of the iceberg. And it shows the wisdom of our bodies: To get rid as fast as possible of a toxic substance.

Wheat is addictive – it contains morphine-like substances that play with your brain and your longings just as cocaine and heroin do. I always picture how the first farmers, sitting placidly and satisfied in their hovels, invited the last hunters who came in from another fruitless hunt for something to eat (the rise of agriculture happened parallel to the extinction from overhunting the very large ice-age mammals – they had bison the size of elephants, and deer like cows at that time. The rise of monotheism happened at the same time … did we feel guilty for the overhunting??). The hunters got their bowl of gruels or their flat breads; it must have seemed heaven to them. As they never got enough of it, they came back for more and more, until they one day decided to plough a piece of land, and settle down as farmers themselves.

So, if you want to get healthy and/or slim, you first have to break the wheat (and corn! And sugar! But those are other topics …) addiction. You don’t die of starvation, if you leave out bread and pizza and cakes and cookies and muffins. You just get healthier. The food to eat: Vegetables, vegetables, vegetables. And some brown rice, as rice does not seem so addictive as wheat. It just doesn’t taste so yummy, yummy that you want more and more of it.

In all of this, I haven’t even talked about what they do nowadays once the too-big, overinflated-by-starch wheat kernel is harvested: They mill it and grind it and take the good stuff out, namely the coarse outer layers that contains vitamins and ls . The make white flour from naturally brown flour, and because it is known that white flour contains nothing healthy and leads to deficiency diseases down the road, the “fortify” the flour with vitamins and iron.

Believe me, nothing is as well “fortified” as the original grain. I mean the really “original” grain which we cannot retrieve anymore because the first grains were so puny – not much more then a few hard nibs in your mouth while you were searching for the really belly-filling rabbit or root. If you want to do wheat at all (and if you are a celiac, you can’t have it ever again! Also not rye and barley; perhaps not even oats), at least stick to dinkel and kamut, some of the older grains. Not as old to go back to the dawn of times, but going back a few thousand years, to the first cultured strains. They contain more hulls and “waste”, less gluten and starch. You also can try sprouted breads where most of the gluten has been used up in the process of sprouting.

Our modern degenerative diseases have to do with mostly four culprits: Wheat, dairy, sugar, trans-fats. Our redemption lies in the plant world: vegetables, herbs, fruit. A few beans, a few nuts. Some fish. And occasionally … a rabbit.

In my thirty years in medicine, I have never diagnosed anybody with “irritable bowel syndrome.”

Not that I didn't want to make the diagnosis. But it always seemed to be the last resort - if there wasn't a better explanation for the patient's symptoms. And there always was.

If my patients came with the label, I quietly looked for a more appropriate diagnosis, mostly some kind of food intolerance and/or infections. And if they came with any of the myriad of gastrointestinal complaints, they deserved a thorough workup.

Food allergies: Physicians differ between food allergies and food intolerance. For the patient the difference is minimal: The only action that will help is leaving out the offending food.

Allergies are mediated either through blood – then they show up in blood tests. Or they are cell-mediated, which means they can’t be detected by blood tests; skin prick test is the way to go then.

If you usually feel good (or even just better) in the morning before you eat, food problems are likely. – Floating stools point to a food culprit, too.

There are rare and dangerous diseases, therefore a doctor should eliminate serious diagnoses. But this is what you can do yourself:

• Write a food journal. Everything that goes into your mouth should go in here – including beverages, pills and chewing gum. A pattern might become clear once you regularly record everything.
• In my experience, these are the most common food offenders: dairy, soy, nuts, gluten, corn – especially HFCS (High Fructose Corn Syrup), nightshades (tomato, potato, eggplant, bell and hot peppers), citrus, seafood, lectins, food colorings, preservatives, flavor enhancers (like MSG), eggs, apples and other fruit, chocolate (though probably less common than people think – it usually are the non-cacao ingredients that cause trouble), yeast. And don’t forget: prescription medication! Recreational drugs.
• Read labels! Of course, foods without labels – like kale and carrots – are healthier anyway because only processed food is required to be labeled.
• Has anybody in your family a bowel disease? You might have the same.
• Jot down pains, headache, heartburn, stomach ache, bloating, diarrhea, constipation, blurred vision, slow urination, skin rashes, blocked nose or ears,
• Don’t eat after dinner – and don’t have dinner late. The sheer bulk in your stomach may create the discomfort; besides it prevents the cell repair that should be taking place nightly – but can’t happen when your body is busy digesting.
• Are you very thirsty – especially during and after a meal? That might be a sign of a food allergy. Don’t suppress your thirst – this is how your body gets rid of the offending food: by diluting it.
• If you suspect food allergies, leave out the whole list above plus whatever you suspect for a week. Then one by one, every few days reintroduce another food from the list. – Sometimes only repeated exposure shows the problem – that happens mostly with cell-mediated allergies.
• Blood-mediated allergies are the quick ones – that can bring you to the emergency room - like peanuts. Never try to force your body into accepting any food that it doesn’t want!
• Slow allergies make you sick over time – by the chronic inflammation in your body. That causes for instance cancer in the long run.
• Take a probiotics regularly. I personally like Primal Defense (this is not an endorsement – only an idea to start with. Begin with a small dose, slowly take more. If a probiotic does not agree with you, change the brand.
• Most people benefit from fish oil – to counteract the constant inflammation that comes with food allergies.
• Chew well.
• Eat vegetables, vegetables, vegetables. Not only are they good for you – they also seem to cause fewer allergies.
• Serious runners suffer from a curious disease called “runner’s diarrhea” (about fifty percent of them.
• Obesity might be a sign for food allergies: We tend to crave exactly the foods that are worst for us.
• And most importantly: Don’t eat it if it hurts you!

Unfortunately, you can even have a bowel disease without any gastrointestinal complaints: About fifty percent of gluten intolerance (celiac sprue) patients never notice anything wrong with their belly. But they might have joint or back pain, diabetes, autoimmune disease, mental fog, depression – and a host of other problems.

“Give us our daily bread” is a prayer. If somebody is out there to listen to this prayer, He seems to prefer to listen to First-World supplicants; the Third World does not need to apply, apparently.

World hunger is appalling, but perhaps it is beneficial that not all people get to have their daily bread. Because our staple bread, surprisingly, contains ingredients that might hurt you.

All seeds – including grains, legumes and nuts – contain indigestible parts. It is a survival strategy for seeds: They don’t want to be eaten, they want to germinate and build new life.

About five to ten thousand (depending on where people lived) years ago, the agricultural revolution happened. Suddenly we were eating grains (the other part of the agricultural revolution was coaxing cows into give up their milk for human consumption). When people still were hunters and gatherers, grains barely ever showed up in their meals – grains then were trifling kernels, not worth the effort. Cavemen ate greens, roots, nuts, small fruit (big fruit are the result of modern hybridization), game, fowl and grubs – whatever was available. Not much was available, so famines and starvation were frequent – especially after mankind had successfully hunted to extinction the huge animals that populated the world in prehistoric times: huge deer, woolly mammoths, giants pigs, and so on.

Agriculture was a step forward. It provided more calories, and reliably so. More children could survive; populations slowly increased.

But grains come with a price: They contain antinutrients (such as lectins, phytates, protease inhibitors) that have negative health consequences. These ingredients interfere with the successful uptake of important molecules – mostly minerals, like calcium – and they are harsh on the gastro-intestinal tract. As they are indigestible, eating them can lead to upset stomach, bloating, diarrhea, even colitis.

But things are never easy: Polyphenols and flavonoids are also antinutrients, and we surely want those in our daily fare (though not in overdose).

Antinutrients can be destroyed or at least reduced by cooking, sprouting and fermentation. About fermentation and its benefits we have already talked. We also discussed raw foods-only diets, and that cooking makes more nutritional components available.

Soaking and sprouting is a method still not used widely enough. I can't marvel enough that the simple fact of adding water to a seed will make it easier to digest (be aware that for some people it is not enough to eliminate the digestive problems). Store-bought sprouts in the past have occasional had problems with germs, alfalfa and soy bean sprouts, for instance - a good reason to do it at home. Just keep your (simple) equipment clean. There are a few tricks for different sprouts from amaranth to Brazil nuts, from mung beans to lentils which I don’t want to discuss here – information is easily found on the Internet.

This is my stress-free methods: Soak in clean water overnight. There are plastic jars available at health food stores with sieves of different sized hole, for small and bigger seeds. One can also just (and perhaps healthier without plastics leaching out) use glass jars and paper towels and/or cheese cloth for straining.

Pour off the water next morning, rinse in clean water (repeatedly, if the water is cloudy) and let stand for sprouting (or beginning to sprout). Eat your sprouts during this day. For me it works – without being too meticulous about it. I like sunflower, flax, sesame, almonds. Make sure you start with seeds that have not been irradiated, roasted, salted or processed in any way; organic is preferable. Make sure you don’t let them sprout for too long, they might get bitter. Experiment with different soaking/sprouting times. Anything longer than two, utmost three days can lead to mold – discard it. Always clean jars and sieves thoroughly.

Add sprouted seeds and nuts to bean dishes, leftovers and as snacks.

If you seem to have “allergies” to every single nut or seed there is, try removing antinutrients by soaking and sprouting. After all, yours might not be a real allergy, you might just not be able to digest certain indigestible food ingredients. Which is determined by genetics.